Sunday, January 8, 2012

7 Habits.......of Highly Unsuccessful People

On January 2, 2012 Forbes magazine published an article entitled "7 Habits of Highly Unsuccessful People." The interesting aspect of this article is that many of us have experienced the consummate CEO that was successful at first, and then.................well you can fill in the blanks. What TSB thought was enlightening is that there have been many individuals in spine that have fallen victim to their own success. TSB encourages everyone to read this article. Here are the 7 Habits;

THE CEO AND THEIR MANAGEMENT TEAM SEE THEMSELVES AND THEIR COMPANY DOMINATING THE MARKET

THERE ARE NO CLEAR BOUNDARIES BETWEEN PERSONAL AND CORPORATE INTERESTS

THEY THINK THEY HAVE ALL THE ANSWERS

THEY RUTHLESSLY ELIMINATE ANYONE WHO ISN'T COMPLETELY BEHIND THEM

THEY ARE CONSUMMATE SPOKESPERSON OBSESSED WITH IMAGE

THEY UNDERESTIMATE OBSTACLES

THEY STUBBORNLY RELY ON WHAT HAS WORKED FOR THEM IN THE PAST

How many of us have experienced an individual or individuals that have fallen prey to one if not all of these categories? Exhibiting confidence is an important element when factoring what drives success. Yet at times, is there a fine line between what is truly attainable and what is fantasy? As an industry, we hear many of the successes, but do we ever learn from the failures? Do we take the time to understand the relationship of causation to effect? How many truly understand leadership? What TSB has learned is that instinct and experience plays a much greater role in leading the right way, than reading some motivational book. Anecdotal quotations will only take you so far, and sooner rather than later reality catches up to you and bites you in the old arse. If you haven't experienced it, how can you understand the challenges and needs of your team? If you've ever been an athlete, you know that relying on your god given abilities will only take you so far and then you have to draw the line between inspiration and perspiration. Whenever someone sets goals, the objective is to make them attainable. How many leaders still live on fault line thinking 20% growth or even 50% growth in a shrinking market? Don't believe it, you be the judge. TSB wants to know, who do you think is a great leader in the industry and who needs some schooling?

258 comments:

  1. Globus... Are they ?

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  2. Sounds like the leadership boys at Nuvasive!

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  3. 4:13 - It certainly does sound like it was written about Nuvasive, doesn't it?

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  4. Big Daddy gonna put a hurtin' on all you clowns this year.

    ~ Tebow Fan

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  5. Globus ?
    Pa Leeese .....

    The company is showing robust growth quarter after quarter.
    In real dollars not smoke and Mirror Mickey Mouse dollars.

    Just wait till the last week in Jan for the news regarding FY 2012. Globus is a frigging powerhouse.

    From my perspective there are two types of spinal professionals in this game.
    People who rep Globus And,
    People who WISH they rep for Globus.

    Gnite

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  6. BORING!!!!! How about a post with some original content for once? For example, do some research and figure out what kind of technology the modern spine sales rep is using in the field to maximize efficiency and get things done.

    Personally, I don't think I could survive without my iPhone 4S. Here's a list of the apps that I use on a daily basis in no particular order of importance:

    1) Dropbox - This app provides me with access to ALL of my files, ALL of the time. My Dropbox includes product brochures, surgical techniques, product animations, journal articles, price lists, charge sheets, etc...

    2) Goodreader - Allows me to view/search/annotate on my phone just about any type of file imaginable. Most often I use this app to quickly locate item specific pricing when filling out charge sheets after surgeries, but on occasion I might also use it to quickly jump to a specific page of a surgical technique or journal article in a pinch.

    3) Digits Calculator for iPad + iPhone - Have you ever been half-way through adding a long list of numbers on the iPhone's native calculator app, and thought to yourself, "Wait a second...Did I just type '255.65' or did I type '265.65'? Damn!! Now I have to start ALL over from the beginning!!" Well, fret no more because Digits Calculator eliminates this annoyance by providing a list of previously typed numbers right alongside the number-pad. Genius!!

    4) Track Packages - Does your company uses FedEx, UPS, DHL, or USPS? If so, this app has you covered. You can track all of your outgoing packages with ease by utilizing the app's "scan" feature. Just scan the barcode(s) on your shipping label(s) before affixing to your package(s), and this app will save, track, and notify you when the packages have been delivered. It's that simple.

    5) Notes (native iPhone app) - I bet you'll never guess what I use this app for. ;)

    6) Camera (native iPhone app) - I can't even begin to tell you how many times I have used the much-improved camera of the iPhone 4S to snap a quick picture of a serial number on one of my loaner sets for later use, or perhaps to take a few quick snaps of the Xrays for an upcoming revision (sans patient info, of course!!) in order to later determine the removal hardware needed.


    What apps are the rest of you using to make your jobs easier? Any ideas for new apps or perhaps ideas for improvements to currently available apps? What about other forms of technology not tied to the iPhone?

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    1. Flight Tracker.... Best app ever!

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  7. I may be biased because I am a Stryker Employee. Steve MacMillan is a pretty well respected and successful CEO. I Think he is a great leader.

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  8. Spineblogger,

    Please spritz your mangina with FDS, put on your girdle and actually contribute to furthering the industry rather than invaginating by laying all your chips on the Don't Pass line.

    ~ The Guy Who Fired You

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  9. TSB
    Heard that the guy who takes credit for firing you, got rid of his top distributors and hired scrub techs, sells to PODS and lost $4 million iin revenue since your departure and the valuation on his company is bupkis, LOAO, maybe his investors should just cut their losses take the tax right off and sink the ship, TSB you win he loses, or should I say the genius loses.

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    1. Come on guy that fired TSB.....respond at least.....show us your mgmt skills have a voice to the people! Right now it's TSB 1, Guy that fired TSB 0. Your buyout price doesn't cover your investors risk....and now PODs lower the buyout potential to CCC- rated.

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  10. Okay, I realize this is way off topic (and this blog for that matter) but which small company involved in total joints has the best line? I am looking to branch out but can't figure out if any of the ankle biters have viable products. Thanks.

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  11. Globus please ...your not a Big boy until you are in the public sector ...you make numbers look better any way you want.....if you did go public your stock would be around 5 bucks aliitle up Alphatec and below NUVA......

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  12. Prestige Worldwide....going public in 2012.

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  14. 6:55
    Smith & Nephew for joints...if you want superior technology!! Ankle biters in the ortho world can't offer much. Understand, ortho is a totally different animal than spine! There's six main players in ortho...outside those, not worth it. Good luck!

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  15. Smith and Nephew has the worst joints of the big players. This is coming from a physical therapist that works with a ton of patients that get smith and nephew, depuy and zimmer joints.

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  16. WOW...dead on for NuVasive. Rydin sure doesn't show any leadership in the organization. I would agree with Steve MacMillen. He seems like a solid guy. I am sure there are the bashers out there.

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  17. sounds like the team at alphawreck

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  18. 7:28
    You are about the 10th nitwit that has posted on here comparing stock prices as if that gives any comparison of the value of the company. There are a few other, simple, variables involved with valuation. I would love to see your portfolio and hear how you pick em! I need some entertainment.

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  19. 5:48

    I use FileMaker to log every case and then email the delivered orders to the manufacturer and hospital. Lets me run reports, even on the iPhone, for any set of data I need. It can capture signatures and photos with each surgery. I also use it to reconcile commission checks to make sure I get paid on all cases and nothing slips thru the cracks. Also helpful for breaking down sales by rep for payday.

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  20. I heard SpineWave getting ready to make an impact!

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  21. TSB..wow...every one of those 7 habits describes Lukianov and Valentine at Nuvasive. How many times have we been told the Koolaiders will "dominate" the market by them? How blurred are the lines between personal spending (plays, sports tickets, parties, international first-class jaunts...) and corporate spending? How many sales managers have been pushed out for not drinking deeply enough from the corporate Kool Aid?

    I could go on...all 7 are dead on for those guys. No wonder the stock has tanked (and looks to continue doing so...)

    Hey NUVA investors...WAKE UP....DEMAND CHANGE.

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  22. 1/8, 5:48...yes...dropbox is sweet. Beats the pants off of various online file folders that are available. I can use it on my mac, my PC, and on my iPad. All my files...one place...no more memory sticks...no more "hmm...is THIS the latest version of the presentation...or was it THIS one...?"

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  23. @7:45, yes me too. I'm looking forward to hearing that Berkshire Hathaway is 4,000 times more valuable than Microsoft.

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  24. Arthrosurface for something different to carry

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  25. Check out the "CloudOn" app for your IOS system.

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  26. 10:26, Excellet post & spot on! How brash is it that Alex continues to trumpet that his Broadway musical "Memphis" is touring the U.S.? Is there not something wrong w/ utilizing corporate email to promote your personal venture? That managment team shows no shame in how it spends the money of its "shareowners".

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  27. Its the frick'n Catalina Wine Mixer!

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  28. Pretty sad...You guys have lost your focus. Innovation and hard work! That is the future!

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  29. Ortho Development is looking for joint distributors, small company with knock offs of expired pattents. Not bad for primaries, just be wary of revisions with any small company.
    Omni Life Science is another small company with some very solid technology and reputable design docs.

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  31. John Stalcup definitely needs schooling!!!

    Great product but he thinks HE invented it ... NOT!!!

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  32. I agree on the Nuvasive comments... Lukianov and his cronies keep promoting themselves, probably to make up their losses on options... can't believe their board doesn't flush the toilet... what a train wreck...

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  33. How about the fact that Lukianov and his cronies all fly to Paris where Cappuccino and his family were on vacation to offer him a "kings ransom" to stay with Nuvasive? He told them no, they are unresponsive and to big. I'm sure the whole trip was "expensed". What a joke!!

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  34. As I read TSB post and before I read the replies, the first thing I thought of was Holy Cr@p Batman, that sounds just like the leadership at NuVasive. (I'm guessing you did too TSB.)

    I can think of a few more companies though...

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  35. On the contrary, TSB was not thinking about NuVasive, but the industry as a whole entity. Considering that game conditions have tightened up in the healthcare industry, we continue to have the same illusions, or should I say delusions. Even smaller companies are failing to keep their surgeon and distributor customers happy. Why? Capital resources are being mismanaged, there is a lack of focus, hospitals are making it difficult for even the best of us to function within an adversarial system, a lack of adequate training programs, lack of sales samples, marketing materials, and attention to detail.

    Lukianov and his Band of Renown are an example of how disconnected you become when you start believing your own press clippings . You lose focus, you start believing you are the company and that you are bigger than the sum of the parts that make up the whole. Anyone can set expectations, it takes a grounded and realistic person to be able to execute, and in the end you fail not because of other peoples inabilities but because of your own DISTRACTIONS. You know what SRV sang:

    Day by day, night after night, blinded by the neon lights
    Hurry here, hustle there, no one's got the time to spare
    Money's tight, nothing's free won't somebody come and rescue me
    I am stranded caught in the crossfire

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  36. Paul Graveline is the best sales leader I've ever met. He shoulders the responsibility of shining up turds like Stryker and now Zimmer, when cushier jobs are available.

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    1. Paul IS the turd! Zimmerman is losing about 30 mil with the corporate raiding and brining in zero dollars. Great leader Paul.

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  37. Can somebody tell me why a facility would benefit from purchasing implants directly from the manufacturer and cutting out distribution. If a facility ia already being reimbursed by insurance on the cost of the current implants and kept whole, what benefit do they get by buying cheaper implants and being kept whole. Please give some reasons why facilities choose to do this and I am not referencing POD's.

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    1. Most of the time hospitals are paid a lump sum for the case. Driving down costs makes procedures more profitable. By the way, you aint seen nothin yet. Wait until ACOs rellly kick in.

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  38. 6:03,

    Because they're still going to charge the same prices to the insurance companies, which will increase their profits.

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  39. 6:03am

    As one of those facilities, cha-ching, cha-ching (and we still save money for the system overall). And we don't let the surgeons run amok either (POD's are not allowed). How is it with the shoe on the other foot? Believe me we all are better off. There are many supporters for what we want. Do you think some of us could do from inside what you claim can only be done by the likes of you? Wake up and join the fun!

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  40. What is the Consensus out there on the LDR VerteBRIDGE technology? Is the nickname the Corpectomy Maker warranted?

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  41. 7:33am

    Can they really charge the insurance companies the same price even if its over what they paid. Is that fraud? Please explain?

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  42. 8:36...yes, they can charge a fair market price to the insurance for the implant. In fact the "cost + x%" arrangements are being phased out (in most cases already are), since those actually provided the facilities a disincentive to lowering costs.

    The next phase is one big bundled price handed to the facility to have them manage it overall. This will be particularly effective in situations where the physicians are hospital employees (a big trend).

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  43. 8:36,

    Thay have been for years. A doc showed me a patient's bill where the pt/ins company was charged five times what my implant company charged the hospital. We charged slightly over $1K per pedicle screw and the hospital then turned around and charged over $5K per pedicle screw. Another hospital only multiplies the bill by three times.

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  44. Well said TSB!!!!

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  45. The comments about NuVasive’s leadership are dead on. They are the most egotistical, self-serving, arrogant people I have worked for. NuVasive is all about Alex, and his cronies, from their stupid Christmas cards with their faces on it, to the dumb cartoon videos they show at company functions with them in it. Their core value of EZTODOBIZ, is a joke. The amount of bureaucracy in NuVasive is incredible

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  46. Just to clarify, yes the hospital bills the insurance the implants at a substantial markup (e.g. 3x). But now almost always, the insurer pays a previously agreed upon (in network) set fee for the entire operation. Hence the motivation for the hospital to now buy implants as cheaply as possible.

    This is the inverse of in the past decades, where a higher implant price was actually beneficial for the hospital. (e.g. 3x of $1000 is more than 3x of $500) So when our industry switched from pushing purchased implant inventory (yes, dating myself, I know) to consigned inventory at a premium price, that was a win-win for the hospital in a big way. No capital budget expenditure and more disposable "mark up" revenue from insurers. No wonder it caught on and became the norm.

    Now what we're seeing is the inverse. Because the hospital wants to maximize the spread between the set fee they receive, and the costs for the surgery, they're happiest to see lower prices from us. Who knows, they may even forego some of the value-added services that have become de rigueur in the meantime (e.g. no charge instruments, rep support in every case, consignment inventory) to get the lower pricing, but somehow I doubt it.

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  47. This comment has been removed by a blog administrator.

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  48. Yes VerteBRIDGE is a "bridge" to a corpectomy. I've heard that the number of split vertebral bodies and device-related complications/adverse events is high - I'm surprised there aren't a lot more MDRs.

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  49. 9:59a - IMO the amount of bureaucracy in an organization is directly correlated to the size and numbers of egos that need stroking. Wait to see how bad it gets as they continue to add worn-out, recycled, old medtronic executives to their "team".

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  50. 11:56, how many MDR's are there for it?

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  51. MDR?????

    Is AlphaWreck be a WMD???

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  52. I know some people that work/ed with Paul Graveline at Zimmer. They say he is as dumb as a box of rocks. They continue to quit instead of working for him. What other company puts a sales guy in charge of operations as the COO? What is happening with the Zimmer / Stryker law suit over this loser?

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  53. 10:59 You don't know jack shit about bureaucracy. I spent ten years working for DePuy and that is bureaucracy. Getting them to do anything is like turning around a battleship. They will run Synthes into the ground in no time. Are you so jaded that you can't take a little holiday humor on a Christmas card? Why the personal attacks? I bet if you spent half the time you spend on this blog going out and selling something you would not be complaining. Never met a rep who was making good money complain about the CEO of a company. My guess is your a shitty rep.

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  54. 1:48

    I agree with you and partially about your comments. I did at one point work for Paul Graveline, and what i will tell you is this. He is without question probably one of the least knowledgable executives in the spine industry, he really not that polished, he can sometimes be embarrassing in front of customers.

    I will tell you this though, and i have to give credit where it is due. He was extremely hardworking, he's got more pride then anyone i think I've ever met, we he has a plan he does just that and is not distracted by anything(sometimes to his fault). Was always willing to take visits to the field, and when plan was always prepared.

    At Stryker there is no question that people thought he was a complete D*ck!! but there were a majority of people that loved working for a guy that dedicated. Ill tell ya one thing, i bet you the guys at Stryker would like him back rather then that empty suit of VP they have now.

    There is no question Graveline was the beneficiary of an up trending market with an under penetrated company, bu there is no doubt that he busted his ass everyday and was willing to work 24hrs a day... The only problem is what takes him al day takes other people in his position half the time. Gotta respect his work ethic though.

    He isn't the reason for Zimmer sucking, Zimmer is the reason for that. he made a smart business decision to accept that job, Large company, shitty spine company. guess he figured that can't possibly get worse.

    As for the law suit, the guys in Arizona had to sit out for a year and then are able to come back. Only problem is Stryker has some Lerch running AZ now. That business will be gone soon as Non-competes are up.

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    1. That dude in az is way better than the last crew. The tools in az that are at Zimmer have zero relationships.

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    2. Duffy is a good guy.

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  55. 2:40 You must be one of those execs still living in the past, as TSB so eloquently put it, you are still living in the roaring 80's when there were few competitors, hospitals loved us, rarely did a doc have his hand out, and consultancies were in their infancy. How little do you understand about the amount of down time that most of us have when we are covering a case, ever sit on your fat ass for five hours only to be told the surgeon was not going to use your product, you couldn't handle the truth, the truth is management in this industry needs to understand what the obstacles are in this market and accept the fact that what you thought was is just a memory.

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  56. 2:40 "run synthes into the ground" how the hell do you run a grounded ship into the ground? I can make better spine products that are more reliable in my garage with a screw driver, paper clip and a stick of gun...you arrogant F's from your "legacy" spine companies w/ your horse terd products. Before Nuva and Globus no body pushed Medtronic because strkyer, Zimmer, synthes and Depuy where happy being medtronic's bit$&@es. To bad those companies never had the balls to do something respectable. Nuva may be a titanic heading for an iceberg but look what they did in a crazy short time frame....from nothing! Is it because they're great? Or because all the legacy companies suck A$$. I say both and I hate the purple faggots...but man up and face the truth the rest of spine blew the chance to challenge the 800 pound gorilla.

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  57. hey 8:13...your boys Nuva and Globus are busy being medtronic's bit$&@es in the courtroom for violating their patents. Maybe the rest of spine respected IP enough not to "challenge the 800 pound gorilla" by ignoring patents..trying instead to challenge that company fairly and legally.

    The 2 companies you champion are busying reaping what they have sown. Nuva's stock is in the crapper, and Globus is stonewalled from going public until they resolve the patent litigation. Give it a few years...both of these organizations will be shells of what they are today. With the litigation hanging over their heads, they cannot attract the capital required to be a viable player in this industry, nor do either of them have pricing power on more than 1-2 products to carry them through the downward price spiral we are in. They will see margins shrink (as if Nuva had any to begin with, given AL's spending on himself), earnings disappear (ditto prior parenthetical), and access to new capital evaporate, excepting at awful terms like big convertible bonds.

    What is left? They will churn some inventory, but never really get the earnings traction required for growth. The debt will pile on, as the perceived need to grow the top line overshadows the sanity of growing the bottom line, and both of them will start to entertain private equity buyouts in efforts to save the organizations from bankruptcy. I give it 3-5 years, and both of these seeming high-flyers land there.

    Thoughts, anyone?

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  58. 12:30 No need to say any more.

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  59. To 12:30
    Yes here is a thought.....
    Listen closely as this may help you in the future when you speak of something that you have no knowledge of
    Time will tell what the future holds for both NUVA and Globus. The companies could not be anymore different in the way they do business. They share 2 things in common. The first is they compete in the spinal hardware industry and the second they are not afraid of the 400lb gorilla ( used to be 800 lb but times are tough) this is the point where you need to listen closely......... Do not mention lawyers, IP or lawsuits and being medtronics "bitches" . The largest EVER lawsuit in regards to STEALING IP was lost by medtronic and paid out by the boys in Memphis to Dr. Gary Michelson.( the folks in Minneapolis had a hard time with that one) Look it up, Gary received enough to buy several small countries.
    So before you throw stones in the future I suggest you exit your glass house first.

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    1. The two actually have a fair amount in common. Neither of them are profitable on an Income Statement. They have a significant amount of consulting agreements with their largest implanters....And 100% of their revenues come from a very crowded, competitive, market which will experience another 8% of deflation during 2012.

      tb

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  60. And they used that IP to win a lawsuit against NUVA and any others in the lateral space.

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  61. Yes, 6:39 MDT lost to Michelson. They're now using the portfolio they bought from him as a weapon.

    Living in the present, 12:30 is directly on-target...

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  62. 6:57
    At the moment they won a verdict - and it was only against NUVA not everyone. It will be 1-2 years before they actually win the lawsuit (if they do) and but then it could easily be 2014. The patent on lateral implants expires in 2015 so even if, when the challenges and appeals are over, they do win (and thats far from a done deal at this stage) and want to go after anyone else they really arent going to have much time and wont win a heck of a lot of damages.

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  63. I do hate it when people immediately call patent infringement stealing. Its really not the case. Does anyone say Medtronic invented lateral surgery - no, do they happen to have an old patent in their archives where someone said "if we are going to put in a cage laterally then what shape would it have to be?" - yes.

    Hardly one of the great inventions in my book and regardless the idea that every other company "stole" this amazing idea is near laughable.

    To quote this person:
    http://www.feld.com/wp/archives/2010/03/are-apples-competitors-stealing-its-patented-inventions.html

    The rhetoric of "stealing" and "theft" surrounding accusations of patent infringement is bothersome, both because substantive patent law doesn’t embrace the concept of theft, and because most patent cases don’t involve credible allegations of actual theft or even copying

    So everyone - think about what you are saying regardless of which company its aimed at. I dont believe NUVA "stole" anything from Medtronic in the same way that i dont believe Medtronic "stole" anyhting from Michealson. Its just a case of which company/person had it written on paper first.....

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  64. 6:59

    I wouldn't use the term "bought" from him. Michelson had danek by the short hairs and could have forced them to close the doors. The only smart thing MDT has done in this regard is hire all of Gary's lawyers to now protect that which they were FORCED to purchase or perish. You can spin it anyway you want but look at the industry from a 30,000 foot view. Who has had by far the most litigation losses? Who has constant bad press? Who is constantly being investigated by the Feds? Whose surgeons are exposed for ridiculous payment platforms? Who has been on the front page of the New York Times and WSJ more than anyone else? It certainly is not NUVA..
    Here is a prediction for 2012..... The new CEO will find a buyer for infuse ( probably a dental or some type of pharma company) MDT will retain the responsibilities for future litigation costs. The synthes- J&J merger will begin to take shape and the gap between the 400lb gorilla and second place becomes much smaller. The company that was once the darling of the industry is fast becoming very similar to a luxury liner that made it's maiden voyage in April of 1912 and I bet if you take a poll of some folks that work in Memphis, they are all looking out their windows for lifeboats and have lifejackets stuffed in their desks
    PS : 7:21 is correct, by the time the lawsuit makes it way thru the courts there will not be anytime left to sue anyone else as the patents will have expired.

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  65. NuVa 540 million in 2011 ?
    Ya - OK

    I can't wait to see how they ran the Jiggity Jiggity Flim Flam Bamboozle on that number.

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  66. About the Graveline comment: So even if you are as dumb as a rock and as long as you work hard everything is ok? I thought being able to get results was what mattered, not how hard you worked. If business followed that logic, why hire college graduates, just hire hard working people to do engineering, accounting, etc. as long as they work hard, doesn’t matter if anything gets done. Could save a lot of money. Do not send your kids to school just send them to a farm to teach them how to work hard. This could be the solution to higher education costs, unemployment due to a lack of skills, etc.

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  67. NUVA stock up 10% today.

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  68. NUVA pre-announced revenues in advance of Q'trly earnings. $540M for the year which is at the top end of guidance.

    This includes $8.5M in revs from Impulse Monitoring. I believe this has much lower margins than the core biz in addition to the enormous acquisition costs.

    It'll be interesting to see what the bottom line looks like - don't get your hopes up all you purple cheerleaders...

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  69. Comparing PG to a rock is really unfair....to rocks.

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  70. Everyone is missing the point, Why didn't synthes make cool stuff like Globus if they stole everything? I don't have to dig deep to notice the synthes garbage and the awesome Globus stuff...either synthes is crazy and locked up all the good ideas in the basement or ??? Get the point people- Medtronic could have added over 1 billion in revenue w/ just lateral if they approached it like the purple but monkeys did....and then they would have done more lateral sells then synthes all together or Depuy all together...ip argument is horse sh$t. The legacy companies did nothing!!! People say where's the innovation...if your argument is that you can't because of ip then why ask that fing question! The big (girls) sucked a$$ and blew it... If they did there jobs nuva and Globus wouldn't be where they are today. PERIOD

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    1. Friendly Reminder to you - Globus currently has 3% Market Share. Synthes has 12%. Depuy and Synthes merger will soon be the largest company in Spine.

      tb

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    2. They will still be a distant second place to MDT. But even they are losing market share.

      Ankle biters are taking over!!

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  71. 12:25 - those big players actually do often just sit on technology and don't develop it. I think it comes from their marketing departments fearing to launch a product that is new, since there is no competitive device with features and sell sheets to ape. Besides, they don't get access to enough budget that they're going to risk their annual bonus on something risky...why not just make another PEEK cage clone, meet your number for the year, take a nice check, and fuggetaboutit.

    You are right that they blew it...but realizing they blew it, they will also dust off those basement files to see if some enterprising surgeon (who has since taken a consultancy with another company, citing that the company is too big or unresponsive) or engineer (who has probably since quit his/her job out of the frustration of having to clone smaller companies' PEEK cages) hadn't already developed the idea for them in the past....

    Then come the IP suits. Fun, huh?

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  72. It's a shame innovation hardly occurred in a golden age of pricing....now socialism gets to take over as spine/technology in med device dies/goes backwards and companies look to see who can make 2 pennies per screw instead of One!

    ReplyDelete
  73. You guys kill me with your misconceived notions about patents. For a patent to be valid and receive legal standing, it must be filed with the US Patent office. Those filings are available to anyone and any company that wants to research and review current standing patents as well as those in the application pipeline. Globus and Nuvasive rolled the diced (Globus rolls the dice with just about every product launch) and gambled on what they thought they could get away with.

    ReplyDelete
  74. Anyone have an Expandable TLIF cage??????

    Who has the best?

    ReplyDelete
  75. 4:16, the correct understanding of patents is that they're bullshit, to broad and restrict any type of technology...your accusations on Globus are correct, however their products are badass! Why does the other top 5 companies make such garbage. As a former Globus rep I can tell you there sh/t simply works-nonstop! It doesn't fail and impress the hell out of the docs!! Why did Stryker(Craper) or synthes(crapthes) not step up and produce awesome stuff??? The fact that Depuy and synthes being neck and neck these years points to Depuy management being god awful and synthes reps being pretty darn good...how the heck did you guys sell that garbage?

    ReplyDelete
    Replies
    1. Too broad, not "to broad". Why do, not "Why does the other..."

      Delete
  76. 4:29, theirs only one expandable TLIF- Globus...anything is a Kia porsche comparison....and it pains me to say that as most of their reps are retarded tool bags with no sales ability...

    ReplyDelete
    Replies
    1. 4:29 there's only one... Not theirs- but you are correct. Only thing worse then a Globus rep is the 24 year old nuva rep.

      Delete
    2. It's "than", not "then", you hypocrite. I'm not surprised that the spine market is on such shaky ground. With so many un/under-educated people in this industry, it's no wonder that the future of spine is so uncertain.

      Delete
  77. 4:32
    Go to the FDA website and find the section that list reports for medical devices which have had an adverse event report. Search Globus and let me know how many adverse events are reported. Please continue to expose your ignorance by stating Globus' products "doesn't fail".
    As for a patent, how would you feel if you developed a novel idea, filed and received a patent only to have someone else develop and sell a product that infringed upon your patent? Would you shrug your shoulders and lament how broad your idea was and how you would be holding back innovation by protecting your intellectual work if you sued? Doubtful. I'm sure you don't leave your front door open to your home. You secure your home to the best of your abilities to protect what you value. Filing a patent performs the same function as locking your front door.

    ReplyDelete
  78. Spine source has a better expandable TLIF cage than Globus. All Peek no titanium.

    ReplyDelete
  79. i agree with 6:04. Spine Source or AMT whatever they go by, has a great expandable cage.

    ReplyDelete
  80. 4:32 your nuts, important earth shattering "patents" like pedicle to pedicle perk rod articulation? that Medtronic bought?? Patent a badass true perk rod pass ... Not the whole kitten caboodle ......how do you compare a true perk rod pass that's dailed in like butter (globus)w 1700 century meat hook that grabs the rod... I.e Globus I.e Medtronic crapy perk systems....nice technology Medtronic. Or there purchase of a "patent"....of a cage in the interbody space... The mockery of nuva's xlif that most of you monkeys where apart of/made fun of at some point 2006-09(before the purple 24yr old dun beetles took a lot of the reps on this blog's sales $) only to take it (xlif) seriously after they created the fing market and technology! (there would be no lateral Mkt w/o nuva.. Did they create lateral? Hell no! Did they create the Mkt? Hell yes! Is it bullshit about the patent infringement??? Hell yes! Is the company annoying? Yes! Do I work for them, hell no!........ Don't be a liberal 4:50.... Be a man, be a conservative, call a spade a spade...if these patents were not so broad, awesome engineering could take place... Don't "patent" a hybrid car damn it! Build a better one!!!!!!!! But alas, you legacy companies aren't good for anything but shining your name badge. How pathetic are most of you on here...you had the name badge, and you still got crushed by Nuva and Globus.....do they really suck as bad as you all say? Or are you bitter because most of you suck? How about we try and grow balls, make this forum better and be real...can Medtronic sue nuva? Heck ya! Is it bullshit??? Does it hurt technology? Absolutely!!!! I'm glad nuva innovated! What the hell did synthes or strkyer do in the last 6years??? What technique would you want on your kids at 3/4 plif, alif(not likely) or xlif? Why is lateral even an option? Because of Nuva! Saying this because it's true, and I hope nuva fails...not a fan! However the truth is the truth

    ReplyDelete
    Replies
    1. This comment has been removed by a blog administrator.

      Delete
    2. 1.)...I just think "it's.".., not "its" . "it's" is the contraction for "it is." Its is the possessive form.
      2.) hiring someone who..., not hiring someone that.

      But I agree, the guy above writes likes sh*t.

      Delete
    3. these new reply buttons are fantastic and they also allow the grammar police to drop the grammar bombs in a concerted, direct, effective manner. Police on everyone - damn bad grammar is annoying.

      Also, try and use paragraphs people. Are you typing so feverishly and frustrated at your computer you can not even separate your thoughts.

      rant over.

      Delete
    4. "These" not "these".

      You are welcome,
      The Federal Bureau of Proper Letter Case

      Delete
  81. Above post was directed to 4:50

    ReplyDelete
  82. 8:13
    That has to be the most disjointed, nonsensical rant I have ever read on this blog. The 4:50 post is stating facts and principles of business law. You on the other hand are stating no factual substance but rather emotional blithering of an angry adolescent.
    Here is a challenge. Name 1 device Globus brought to market that another company didn't already have released to the market or patented?

    ReplyDelete
  83. 8:13
    Sounds like you have a love affair with Globus and NUVA but claim to not work for either of them. Could it be you used to, and your rants and obvious lack of ethics in regards to observing and abiding by rules got you booted. Maybe you should swallow some if not all of your piss and vinegar and go pick up my dry cleaning.

    ReplyDelete
  84. If you have a doc you're friends with ask him a question. Would he be upset if another doc used his research and published studies without giving him credit? It's called plagerism. The same act will get you thrown out of college and for good reason. It shows dishonesty.

    ReplyDelete
  85. Let's take a look at the Spine Source expandable cage.
    1) it only expands at the distal end using a cute 'teeter totter tecnique'.
    2) it is FDA approved only to be used in pairs (PLIF). Not TLIF
    3 it's a POS

    Now the Globus Caliber.
    1) approved for either TLiF of PLIF.
    2) the entire cage expands across the end plate for uniform distraction.
    3) 15 degree option for L5/S1
    4) not a POS

    You be the judge.

    ReplyDelete
    Replies
    1. Spinewave Staxx is the standard that your POS is measured against. Now Stewie, go back to your room!

      Delete
    2. How does Caliber restore lordosis in the lumbar spine while expanding in parallel. Also where does the bone graft go. Last time I checked we were after lordosis restoration, anterior column support, and most importantly fusion.

      You sound like a marketing geek for Globus with all the FDA approval garbage.

      Delete
  86. 9:09 Get over yourself, you're a sales guy. RELAX, we all get that you think YOUR TLIF CAGE IS BEST.

    Laughing,,

    ReplyDelete
  87. 9:09 - Did you use the word "cute" when describing a spinal implant???

    I think that is so adorable......now go wash your VW Beetle and change that rainbow bumper sticker!

    ReplyDelete
  88. 9:09- Rule #1 of Sales "know your competition."

    Spine Source (Wave Cage)
    FDA approved for a Bi-Lateral PLIF

    Spine Source (Wave-O)
    FDA approved for a TLIF
    **so as you see, you mental midget they do have a TLIF option

    To your point about distal only distraction opposed to "Uniform Distraction".

    Last time i checked the Lumbar Spine had a lordotic curve which means it is optimal to have more of a distal distraction rather then uniform. In theory that means your cage reduces the Lumbar curvature and essentially gives patients flat back. Great job on the sales pitch though. trying getting a surgeon NOT paid buy Globust to use that thing.

    So go back to your 5 x 5 apartment in hopes that one day you will have a mansion. Take off your Globus Cheerleading uniform and go sell something, and please stop telling your surgeons you guys are going public this year cause it isn't happening!!!!

    NOW GO GET YA SHINE BOX!!!!!!!!

    Yours Truly,
    Rep from company already public and proven!
    AKA: Your future boss, till I fire your ass!

    ReplyDelete
    Replies
    1. You must be very proud of yourself. Haha.
      I mean, working for such a powerhouse like spine source?

      Let's face it, you are a nobody and nothing more than a flea on the ass of the spinal community.
      Hold your head high moron.
      By the way, caliber is lordotic and offers two lordotic options.

      I encourage everyone to google spine source wave-o to see the junk of plastic garbage this person refers to as a TLiF cage.
      Keep the shinebox you will need it to generate revenue while you look for your next job in pharma.

      Delete
    2. Wave O has two lordotic options as well my friend. Nothing against Globus but you should get your competitive facts straight before you shoot off.........

      Delete
    3. Is Caliber available in oblique lordotic configuration? Yes you can place a lordotic implant unilateraly but unless the restoration of lordosis is oblique (midline to lateral) you are creating a coronal imbalance. I'm not sure the caliber has this option similar to other cages static and insitu-distractible that account for placement across midline at an oblique angle. Curious to know.

      Delete
    4. Hold on - placing a lordotic spacer obliquely? How often does that happen?

      Delete
    5. Hold On------- Obviously not enough if your marketing your Globus Caliber as a TLIF implant. If you are going to use a unilateral implant and ARE NOT placing it in a medial/lateral orientation in the anterior 1/3 of the vertebral body than you ARE creating coronal imbalance in that intervertebral space. Not saying it can't be done or hasn't been done thousands of times with parallel implants but if you had a choice why would you do it? If you don't understand the kinematics or the design of an implant that is obliquely lordotic than time to start studying.

      Delete
    6. Caliber comes in two lordotic varieties Tard Boy.

      Delete
  89. Spine Wave is not really competition for many reps. Its a novelty item.
    I tried to work with them last year and the VP is an asshole. In a watch your
    back kinda way. Talks just like the guy above.

    ReplyDelete
  90. TSB, love your blog but not a big fan of the new setup. I don't really like how it posts the reply below a comment as opposed to a showing the newest response. Just my two sense, but it will be hard to see new responses when they're halfway up the page.

    ReplyDelete
    Replies
    1. "... my two sense." Hysterical.

      Delete
    2. Are you for real? Where would you like the response to be? You must be the tool who posts number 124 on the list referring back to one of the top 10 posts.
      Just my too scents.

      Delete
    3. Sorry douche bag. I have four kids, was a little tired after being in the OR all day and made a grammatical error. I didn't realize that you never made a mistake. Looks like you had a fun Friday night on TSB. Get a life you toolbag. I was only trying to offer some constructive criticism and suggest that it's harder to scan all the way up to read responses. Please tell us where you were educated since you seem to be so smart?

      Delete
    4. I know him, he prefers to be called "Mr. Douche Bag." My two sense is beyond a grammatical error, it goes on into you are not an MD at all, you are some terd who stayed at a Holiday Inn Express last night. "My two scents" pretty funny. Lighten up, "Doc."

      Delete
  91. Have to love all the English teacher's on here. At least you guys will have a fall back position as the likely first to go. You're just revealing your annal skinner/farmer ways. Hope you all make it to management quick(and hide out for 10 years) because I'm sure you can't sell a damn thing. Losers.

    ReplyDelete
    Replies
    1. Plural of "teacher" is not "teacher's".

      Fail.

      Your selling efforts likely are just like that too, and your smarter doc customers laugh at you behind your back.

      So sorry, but it is true.

      Delete
    2. It's so true. Some of you uneducated reps crack the sh*t out of us. We just can't believe that some of you are able to command six figures with such little education. That's truly the sad state of our country and society today.

      Forget about exposing PODs in the WSJ -- let's expose the scam of implant reps with little to no education/skills making more than virtually all other professions with higher standards (e.g., engineering, education, nursing, physical therapy, pharmacists, accountants, etc).

      Instead of bad-mouthing your surgeon customers, you should be counting your blessings that you are getting away with the greatest fleecing of America.

      Delete
    3. They have to pay us a lot to put up with you... If the education level of your reps is so concerning how about picking a rep for their knowledge, skill and dependability instead of the company with the best deal, son, daughter, cousin or best friend as your rep. You created this problem, now go back to your pod and shut the f@&k up, were not buying the bs your selling. The greatest fleecing is physicians and Medicare, period. Much more than the Wall Street bailout because tax payers get saddled with that bill anually.

      Delete
    4. You have to give him some positive reinforcement. He did use "loser" correctly. Though it may be up for debate whether by accident or because he saw the word tattooed so often on his papers in school.

      Delete
    5. Hey, 3:39 PM, you proved our point. It's "WE'RE not buying the bs YOU'RE selling", not "were not buying the bs your selling", you complete imbecile. Now go look up that word in the dictionary and go back to stocking the shelves in the OR for us. Lol.

      Delete
  92. One thing becomes obvious reading these entries, and that is that the level of anatomical, pathological and engineering knowledge the average poster possesses is way less than it should be. Most of you would not be granted entry in my OR.

    ReplyDelete
  93. Been seeing more activity from Coflex in my area. Anyone else seeing the same?

    ReplyDelete
  94. Did Alphatec end up pulling PureGen from their portfolio?
    Parcelling Laboratories mentions on their website that they supply PureGen to them.

    ReplyDelete
  95. TSB, I second 6:52's comment. Would be nice to have some way to quickly see only new comments or replies.

    ReplyDelete
  96. Zimmer Spine is going to have a huge 2012!

    ReplyDelete
    Replies
    1. Really. With what!
      Hopefully your statement was meant to ooze sarcasm and not a forecast.
      Otherwise...
      Could someone please take the crack pipe from this fool?

      Delete
  97. Hey, A-Holes When I look at my wrist, I realize what losers you all are.!This watch costs more than your car. I made $970,000 last year. How much'd you make? You see pal, that's who I am, and you're nothing. Nice guy? I don't give a crap. Good father? Frig you! Go home and play with your kids. You wanna work for Nuvasive - close! You think this is abuse? You think this is abuse, you sucker? You can't take this, how can you take the abuse you get on a sales call? You don't like it, leave. _I_ can go out there today with the materials you've got and make myself $15,000. Today! In two hours! Can you? Can YOU? Go and do likewise. A-I-D-A. Get mad you son of a bitches. get mad. You want to know what it takes to sell XLIF? It takes BRASS BALLS to sell XLIF. Go and do likewise gents. Money's out there. You pick it up, it's yours. You don't, I got no sympathy for you. You wanna go out on those sales calls today and close, CLOSE. It's yours. If not you're gonna be shining my shoes. And you know what you'll be saying - a bunch of losers sittin' around in a bar. 'Oh yeah. I used to be a spine salesman. It's a tough racket.' These are the new leads. These are the Globus leads. And to you they're gold, and you don't get them. Why? Because to give them to you is just throwing them away. They're for closers. I'd wish you good luck but you wouldn't know what to do with it if you got it. And to answer you question, pal, why am I here? I came here because Alex asked me to. He asked me for a favor. I said the real favor, follow my advice and fire your rotten butt's because a loser is a loser

    ReplyDelete
    Replies
    1. This is great 4:18! I just started reading this blog a couple of weeks ago and you are so spot on. I love your creative dialogue and the character development. It's so like some of my peers at NUVA. What a bunch of tools. It's like every time I'm at the National Sales Meeting it's all I can do to avoid these a-holes at the bar. Like fending of a bunch of horny poodles. Ha, ha. Love your comments and keep up the unique input! NUVA really is a great company though. Alex has helped me grow a lot.

      Delete
    2. You cant blame them for acting the way they do. Avg Nuva rep is 24. Short on experience and low on maturity. Drunk on purple Koolaid.

      Delete
    3. 8:30am, just because the new NuVa rep in your po'dunk little territory is 24, that doesn't mean that 24 is the average age of every NuVa rep in the country. You sound ridiculous.

      Delete
    4. Great movie reference. ...second place? A set of steak knives.

      Delete
  98. ...and then 4:18 awoke from his stimulating wet dream, changed his underwear, went back to bed, and snuggled up ever so close again to Momma hoping once again to dream of greatness. The End

    ReplyDelete
  99. Depuy is going all direct except three distributors. Time to look for another job boys. They will give you one decent year and then the garbage pay comes.

    ReplyDelete
    Replies
    1. word is the remaining distributors will also go away once the dust settles ... 2 years at most. Direct reps will have capped territories at 2 mil

      Delete
    2. That's great for other companies looking to get their good reps.

      Delete
  100. The question is, does Synthe Spine follow suit with their reps and have them all sign new contracts with an 18 month non-compete and commissions of 8 percent?

    ReplyDelete
  101. I LOVE the NUVA guys piping off like they REALLY built something out there- all by themselves. Not too hard to do when you create a new market opportunitiy with XLIF- this isn't however, great salesmenship- it's great engineering and R&D by Alex and team. The sales people are just vehicles to promote the product. Good for you 4:18 that you made a lot of dough- there are very few of you left and by publishing your W2 out here, I am sure the NUVA folks know exactly who you are. You represent the company really well- and now, you may have your opportunity to see if you can really sell as NUVA will most likely wack your territory to keep your arrogance under control.
    Don't every forget for a minute, you as a rep are NOTHING and you never will be. Your window for big dollars is coming to and end very very soon.
    You also failed to mention how many consultants and "study buddies" you have in your territory.

    The pine space is an F ing joke and they days of the rep in the OR - and subsequently your big income - are ending. Go choke on your ego-

    ReplyDelete
    Replies
    1. Hey...your statement would have more impact if you did a little spell / grammar check.

      Delete
    2. Dude, chill. 4:18pm does not work for NuVa. He's being sarcastic.

      Delete
    3. 9:40 @ 1:34... I knew that. Just a quick proof read makes the statement flow with more effect whether funny, sarcastic or just pathetic. Having to stop and re-read loses it's punch. By the way....I have EVERY NUVA rep I have EVER met.

      Delete
    4. 9:40 here again...OK I f'd up on my OWN response. Wife cooking up some crow right now.

      Delete
  102. Anyone have confirmation that Mike Simpson (formerly of OFIX) has been picked up by the VBros to assume president/ ceo of their Small Bone business?

    ReplyDelete
    Replies
    1. SBI is still doing business?

      Delete
    2. Yes, they are huge in Turkey!

      Delete
  103. I'm thinking of going to work for Globus. They must have an awesome training program. I watched one of their reps the other day put gloves on and assemble the screwdriver and implant for the scrub tech during a case. He didn't even have to wash his hands or anything. Anyone familiar with this type of training?

    ReplyDelete
    Replies
    1. Have any of you actually been on the FDA's website and pulled up all of the adverse events reported for Globus product failures? There are something like 15+ separate reports of broken Transition screws in just the last year alone. This, my friends, is just the tip of the iceberg.

      Most product failures are not reported, and I think we all know why. Most often, pedicle screws only break when a patient fails to fuse (aka pseudoarthrosis). Much like a pseudo, the Transition system allows for too much movement (Globus product literature claims that the plastic spacers are 3 times softer than the Dynesys spacers...as if this is a benefit), and this movement is stressing the screws beyond the point of failure.

      Surely I am not the first person to notice all of these failures. How has this not been investigated yet, and why on earth has Globus not pulled this product from the market?

      Delete
    2. That rep should be banned from the hospital. That is a violation of about 20 different codes of conduct. It does not matter what his training is. He can be a surgeon but unless he is credentialed at that hospital...he's putting everyone in that room at risk if something went wrong. The plaintiff attorney's would bury everyone and all would pay.

      Delete
    3. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/Results.cfm?RequestTimeout=500

      Dang...that's a lot of reports for such a young company!

      My experience...less than 10% of actual failures are reported to the manufacturer...

      Take for example this report:

      http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/detail.cfm?mdrfoi__id=2347333


      ...I can't remember seeing a normal broken spinal rod in years. This was just a simple 5.5 rod. What...are they making this stuff out of discount third-world material or using cheap sweatshop labor or something? The volume of broken stuff is amazing. That should be a bigger WSJ story than a few stupid greedy PODS!

      Delete
    4. I have seen 7 cases of the Talon pedicle screw heads breaking off. Not popping off like Synthes but completelt shearing off. They were only a few days or weeks post-op, not long standing non-unions. I have seen this happen with two different surgeons so I don't think it's sureon error. This screw is sold by several different companies. Total reported to FDA = 0. Why you may ask? Because they are used by PODs! I wonder how many other adverse events are occuring by consultants and POD surgeons and not being reported to cover their arse.

      Delete
  104. Have any of you actually been on the FDA's website and pulled up all of the adverse events reported for Globus product failures? There are something like 15+ separate reports of broken Transition screws in just the last year alone. This, my friends, is just the tip of the iceberg.

    Most product failures are not reported, and I think we all know why. Most often, pedicle screws only break when a patient fails to fuse (aka pseudoarthrosis). Much like a pseudo, the Transition system allows for too much movement (Globus product literature claims that the plastic spacers are 3 times softer than the Dynesys spacers...as if this is a benefit), and this movement is stressing the screws beyond the point of failure.

    Surely I am not the first person to notice all of these failures. How has this not been investigated yet, and why on earth has Globus not pulled this product from the market?

    ReplyDelete
    Replies
    1. Sorry for the double-post. I accidentally posted as a "reply" to 11:29am's post.

      ~2:15pm

      Delete
  105. Rumor has it that Newt Gingrich is going to be the guest speaker at Nuvasive's NSM this week, followed by a performace of "Memphis" for all to enjoy. The Cheetah Ball, an event that all shareowners & board members should be proud to enjoy!

    ReplyDelete
  106. The Packers just got dominated by the Giants the way NuVasive is going to be owned by Danek!

    ReplyDelete
    Replies
    1. I doubt there is still anyone left with MDT who was with Danek Medical

      Delete
    2. 5:05pm, are you really comparing the company you work for (Danek) to the team that had a terrible season and BARELY eked their way into the playoffs with a 9-7 record? Way to shoot for the stars, buddy!!

      Delete
    3. Yes, eked their way in and beat the best team in the NFL at home! The difference is the Giants are winners! MDT are overt losers and there is NO ONE left from the Danek days! The closest thing is the street named after Sofamor Danek down in Memphis.
      How many times did they adjust the Q2 number so they could hit objective? 3 or 4? And they sold their soul and will miss again this quarter! That's what you get when you can't get rid of dead weight and put a Kyphon loser in charge of your sales force! Load the shelves boys! Great strategy! Doug King should have been run out of town but he seems to always get a promotion instead. Must have pictures of someone with a goat?

      Delete
  107. Which three Depuy distributors are being spared?

    ReplyDelete
    Replies
    1. The Depuy r in my area said New York, Philly, and Kentucky are good until their contracts expire. Not sure if that's true but he's leaving and joining us.

      Delete
    2. Strong rumor Depuy is launching a "rep-less" system for lumbar. Goes right along with devaluing the reps. Get ready for an exodus.

      Delete
    3. So Depuy keeps the largest distributors in the country. Consequently, the success comes at a price since they are the least ethical distributors bar none. Nothing is out of reach for these guys, primarily NY. I give it to them, they get the business but they are as dirty as they come. Some of the crap they pull.

      Delete
    4. I left Depuy a few months ago. The system is MDX. It auto re-orders and bills the account. The screws are sterile packed and loaded onto a Pyxis type machine and connected to Depuy. The direct model was not for me. 18 month non-compete, no thanks. Change in compensation after 12 months, no thanks. Implementing a system to keep me out of the OR, pass. I worked there for over 7 years, it was a good distributorship, too bad. With change comes opportunity....

      Delete
    5. If that is true ? god help us all

      Delete
    6. Fing machine stole my quarterJanuary 17, 2012 at 4:26 PM

      Sounds great...but 1) who sells the machine to the accounts, 2) re-stocks it regularly, and 3) gets full, clean, sterile sets into it? Stick in your 2 quarters...out come four surgical trays...wrapped, sterile, Q/C'd. Don't think so.

      So you sterile pack a few screws and cages & put them in there. BFD. Rep still needs to take care of the account, be in surgery, plus F around with the vending machine when it jams and make excuses how DePuy has "never seen this kind of malfunction before".

      God help us reps? No...God help the poor patients lying on the table unaware that the nurse and rep are in the hallway banging on the machine like the Hansen brothers in Slapshot. "F&^%ing machine stole my quarter!!!!"

      Delete
    7. I've had 3 depuy reps approach me in regards to meeting with my distributor. just in the last few weeks.

      Delete
    8. DePuy has that machine in Arizona. Great point that they are now going rep less. The new rep is a cable modem and an Internet connection to Boston and the account is good to go.

      Delete
    9. Dying laughing at the Slapshot reference! Great call! I agree that a rep will be still needed but Depuy thinks with their complete coverage (Ortho,trauma,spine) that they will be able to push this through and screw over the reps in the process.

      And if I were at Synthes, you'll have a job but it's not what it was.

      Delete
  108. BTW, back to clinical talk instead of trash talk. 16,000 SpineWave stackables later, I know it works. Give me your worst collapsed disc and I will convert you. Can't wait for the stackable lateral, something that will get me into lots of difficult accounts this year.

    ReplyDelete
    Replies
    1. How are you packing your stackable cage with bone graft 6:52am? I know you can't pack the cage before insertion so you must be filling it with bone cement. How well does that fuse?

      Delete
    2. Please be more intelligent than that 9:49. Bone cement? Do you not know anything about current grafting options? There are graft and/or bone mills that will yield material viscus enough to go through funnels. How much volume does the center of any of the monolithic cages really hold? It's a very small amount, even in the largest cages. Maybe 1 to 1.5 cc's max. Do your customers pack bone in the disc space before putting a cage in? Guessing they do to promote centintal fusion. SW users do the same and then pack more graft in around the cages after insertion, just like your customers do. All with less BFH (big fucking hammer for you rookies) needed to insert the cage. Less risk of a lot of bad shit when using the BFH. Expandable is here to stay. Some good options out there, but SW is IMO the best.

      Delete
    3. SW boy. You really are an idiot. Most cages only hold 1-1.5cc's of volume. Most lateral cages hold anywhere from 3-4.5cc's of volume. Keep drinking your lame ass kool aid. SW is done.

      Delete
    4. 10:56am, you are obviously some sort of marketing hack for SpineWave, and know nothing about lateral access spine surgery.

      Delete
  109. Just a waste of time and money, which could be better spent instead on simpler insert and rotate technology.

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    Replies
    1. Agreed. Let us continue to reinvent the wheel ad nauseum with these types of devices. Most of the TLIF's and Laterals that I do rarely go beyond a 10mm spacer. The expandable spacers are saving us from using three trials?! I doubt this is worth the extra cost of the implants. Take your time and appropriately trial your implant and you do not need these widgets. I have also noticed a lack of tactile feedback from these types of devices that may promote over distraction of the affected level increasing the likelihood of compromising the ALL in laterals or the facets in TLIF's. I would rather use an insert and rotate or impacted spacer with a mindful knowledge of the endplates. Not to mention you are expanding the device in the softest part of the bone.

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  110. What's going to happen to Alphatec?

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    1. Kaboom! Heard they just lost another big group.

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    2. What big group?

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  111. SpineWave: 16000 implants that work
    Gobust: hardly any
    SW: 1 implant expands up to needed size, therefore no sizing
    G: multiple implants required bc they only expand 4mm, must still size and choose an implant
    SW: no window needed if correct technique
    G: .235 cc's of graft that bounces around after expansion
    SW: Not slimy
    G: Slimy
    End of story

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  112. Who has a peak expandable coprectomy like the Globus Xpand-r

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    1. not that I have ever seen. If I Globus has one semi unique implant it is XPAND-R. Their are a few downsides that they may have fixed: Small Axial hole for graft and the possibility that you can "smear" the PEEK wheel/gear if you are not perfectly seated with the stainless steel expanding instrument. Other than that (Which may have already been fixed since the last time I saw it), the device is very nice and unique.

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  113. Who invited the SpineWave guy to the party? When does having one cage make you qualified to talk spine?

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  114. Spine....Wave...Up Side Your Head! I said, Spine Wave Upside your Head! What! What!

    Fat Ass PerryTaylor.com

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  115. Hey, Idiots, we need to address something more serious in our industry!!!! I would appreciate it if current Depuy reps, Depuy employees and informed individuals would comment on the previous post concerning this new MDX system. Also the comment referring to Depuy going direct.

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    1. Hospital's have been trying to remove spine reps to get a better price, for a couple of years.
      Isn't this the model that next spine uses? If Depuy is starting to use this model to gain or keep share
      Others will follow. If Mdt and others follow we are all in trouble.

      The question is why would a company do this? Drop Asp by half and loose their
      Only advocate they have on the street. Not sure if this is a good long term
      Growth strategy for a company?

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  116. For the love of god, can we get a new blog post?

    I feel like a passenger on a cruise ship with a captain that abandoned the ship

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  117. New subject, here is one.

    Small company, possible big FDA violation. Did anyone see the recent press release that came out from a small company by the name of VG Innovations? I believe FDA regulations prohibit marketing or advertising of combination products without prior approval from the FDA itself. In fact, the FDA has a division known as the Office of Combination Products that must pre-approve any use of or advertising of these types of products.

    In the release, the company states that the new implant's design "allows the surgeon the ability to insert any type of biological product into the dual graft chambers for direct host-bone surface contact, to enhance fusion".

    We all know that spinal implants (cages, etc.), with channels or holes, have existed for years and yes, surgeons have inserted products into the channels or holes in an attempt to fuse the two opposing bony structures. However, in my 20 years in the spinal industry, no company has produced a press release or marketing / advertising material that states for a surgeon to insert "any type of biologic product" into their implants. The release also states that "direct supplementation of biological products to the implant surface should enhance the implant fusion". So, in my opinion, there is a clear and precise intent here to violate FDA policies. And will someone please tell me, what is implant fusion? I have never seen an implant fuse per se, but I have seen fusion occur through an implant.

    Sure, a surgeon may choose to insert a biologic product into an implant, but the manufacture is not to imply or suggest it in any way, especially in its marketing or advertising materials. One can look in the advertising or marketing materials distributed by the major spine companies and whenever a spinal implant is depicted with a channel or hole, it is always depicted with autograft.

    This is a possible FDA violation and could lead to potential repercussions, especially for a small company.

    VG Innovations, LLC Announces the Release of its Latest Advancement in Facet Fusion Technology, the VerteLoc v2.5

    St. Petersburg, Florida (PRWEB) January 17, 2012

    VG Innovations, LLC introduced the first dual geometric facet implant to the spine market in 2008. The VerteLoc implant is unique to the spine market because of the innovative design rationale and engineering. The body of the implant is rectangular in shape, which limits motion in flexion/extension. Whereas the dual vertical stabilizers rest between the facet joint surfaces, and serve to limit motion in both torsion and lateral bending. Our ‘vertebral lock’ allows the joint to heal through the natural process of fusion.

    Today, VG Innovations is releasing its latest advancement in facet fusion technology, the VerteLoc v2.5! The new VerteLoc v2.5 implant incorporates a series of holes for infusion of the allograft implant interface. VGI’s innovative design allows the surgeon the ability to insert any type of biological product into the dual graft chambers for direct host-bone surface contact, to enhance fusion. Direct supplementation of biological products to the implant surface should enhance the implant fusion.

    continued at http://www.prweb.com/releases/2012/1/prweb9103863.htm

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  118. Aren't their devices biologics (allograft) and not a PEEK or Ti cage? IBFDs are cleared for use with autograft, but this isn't an IBFD - it's a bone dowel with a fancy shape.

    Nice try though Eliot Ness. You can now move on to spreading misinformation about something else.

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  119. zimmer is blowing up direct team and distributors.........

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    1. No direct or distributors? What's their plan?

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